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Billing code 81020 · Lab & pathology

81020 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $4.23 for 81020 across 45 states, from $2.52 in Nevada to $5.08 in Iowa.

Data as of Oct 5, 202645 statesEvery rate links to its official source

States publishing
45
National median
$4.23units vary by state
Lowest
$2.52Nevada
Highest
$5.08Iowa
Answer

What does Medicaid pay for 81020?

45 state Medicaid programs publish a fee-for-service rate for 81020. The national median is $4.23 (units differ between states). Iowa pays the most, $5.08, and Nevada the least, $2.52, a 2.0x spread.

State ranking

81020 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 45 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Iowa Source · since 2013-07-01$5.08——Plans must pay at least this—
2Texas Source · since 2019-07-04$5.07——Plans negotiate; applies out of network—
3Wisconsin Source · since 2018-01-01$4.70——Plans negotiate; applies out of network—
22Missouri Source · since 2026-07-01$4.23——Plans negotiate; applies out of network—
23Mississippi Source · since 2022-07-01$4.23——Plans must pay at least this—
24West Virginia Source · since 2023-04-01$4.23——Plans negotiate; applies out of network—
44Florida Source · since 2026-01-01$2.76——Plans negotiate; applies out of network—
45Nevada Source · since 2017-01-01$2.52——Plans negotiate; applies out of network—
See all 45 states for 81020 — start free

37 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 81020 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 81020?

It depends on the state. Of the 45 states with a published fee-for-service rate, the median is $4.23. Iowa pays the most ($5.08) and Nevada the least ($2.52).

Which state pays the highest Medicaid rate for 81020?

Iowa, at $5.08, effective 2013-07-01.

Do managed-care plans pay the same rate for 81020?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.